咬肌瓣改善腮腺浅叶前缘良性肿瘤术后并发症的临床研究

Clinical effect of masseter muscle flap in improving postoperative complications of benign tumors at the anterior edge of the superficial lobe of the parotid gland

摘要:

目的 分析咬肌瓣改善腮腺浅叶前缘良性肿瘤切除术后并发症的临床疗效。方法 回顾性分析2020年1月至2021年1月于重庆医科大学附属第一医院行腮腺浅叶前缘良性肿瘤切除术的患者共42 例，试验组18 例进行同期咬肌瓣旋转修复；对照组24 例不进行同期肌瓣的转移，仅拉拢缝合。随访收集分析以上所有患者术后半年内涎瘘、一年内味觉出汗综合征（Frey’s syndrome，FS）发生率及一年内凹陷畸形的主客观评分。结果 通过SPSS 25.0软件进行统计学分析，试验组和对照组凹陷畸形主客观评分有统计学意义（主观：1.33±0.84 vs. 2.46±0.78，P=0.000；客观：1.00±0.77 vs. 2.58±0.65，P=0.00）；试验组与对照组涎瘘发生率（5.56% vs. 16.67%，P=0.370）与FS发生率（0.00% vs. 4.17%，P=1.000）无统计学意义。结论 咬肌瓣对腮腺浅叶前缘良性肿瘤术后的凹陷畸形修复有一定临床意义，可能是腮腺肿瘤术后缺损修复的新方法。

Abstract:

Objective To investigate the clinical effect of masseter muscle flap in improving the complications after resection of benign tumors at the anterior edge of the superficial lobe of the parotid gland.Methods A retrospective analysis was performed for 42 patients who underwent resection of benign tumors at the anterior edge of the superficial lobe of the parotid gland in The First Affiliated Hospital of Chongqing Medical University from January 2020 to January 2021， among whom 18 patients in the experimental group underwent masseter muscle flap rotation repair simultaneously，and 24 patients in the control group did not undergo muscle flap transfer and only received closure and suture. These patients were followed up to record the incidence rate of salivary fistula within six months after surgery， the incidence rate of Frey’s syndrome（FS） within one year after surgery， and the subjective and objective ratings of depression deformity within one year after surgery.Results The statistical analysis using SPSS 25.0 showed that there were significant differences in the subjective and objective ratings of depression deformity between the experimental group and the control group（subjective： 1.33±0.84 vs. 2.46±0.78， P=0.000；Objective 1.00±0.77 vs. 2.58±0.65，P=0.000）， while there were no significant differences between the two groups in the incidence rates of salivary fistula （5.56% vs. 16.67%，P=0.370） and FS （0.00% vs. 4.17%，P=1.000）.Conclusion Masseter muscle flap has certain clinical significance in repairing depression deformity after resection of benign tumors at the anterior edge of the superficial lobe of the parotid gland， and it might be a new method for defect repair after surgery for parotid gland tumors.